Effect of Surgery on The Prognosis of Stage ⅢB non-Small Cell Lung Cancer

Abstract For patients with stage IIIB non-small cell lung cancer (NSCLC), the current recommended immunotherapy maintenance treatment after concurrent chemoradiotherapy is not demonstrated whether such patients can be benefit from surgical treatment. We collected clinical data from patients with stage IIIB NSCLC from the surveillance, epidemiological, and final results (SEER) databases. Kaplan-Meier analysis and Cox proportional hazards model were used to analyze the effect of surgical treatment on the survival of stage IIIB NSCLC. We use surgery as a variable to divide into surgical and non-surgical groups. Between the two groups, only age is different (p = 0.017), and there is no significant difference at race (P = 0.531), gender (P = 0.051), tumor primary site (P = 0.385), tumor differentiation grade (P = 0.103), T stage (P = 0.094), and N stage (P = 0.071). Univariate and multivariate analysis showed that gender, tumor differentiation, stage and primary site had an effect on overall survival. Kaplan-Meier analysis showed that the median survival time of stage IIIB NSCLC in the surgical group (13 months, 95% CI (7.400 to 18.600 months)) was higher than that in the non-surgical group (3 months, 95% CI (2.482 to 3.518 months)) was significantly prolonged by 10 months (P < 0.001). The Cox proportional hazard modelled analysis showed that the overall survival of stage IIIB NSCLC was 2.395 times the 95% CI (1.77 to 3.241 months) for the non-surgical group (P < 0.001). We conclude that some patients with stage IIIB NSCLC who can tolerate surgery may benefit from surgery.